Booklet for the Nlinnesota Test for Differential Diagnosis of Aphasiabv Hildred Schuell. Ph.D.

C L T N I C A L R E C O R D O F P A T I E N T

NAMF BIRTH DAT ITTHPLACE

oFscHoor occuPATtoNEXAMINATION DA ET PHYSICtAN

FILE NO.---ETIOLOCY ON5ET DA

SIDE OF P^RALYSIS- FANDEDNEST CLASSTFTCATTON

S U M M A R Y O F T E S T S C O R E SThc fi3ures in parcnthesis indicatc the numbcr of items on thc tcst. Writc the score obtained aftcr thc coloa.

A. Auorony DrsrunaexcEsl. Rccognizing common words ( lE ) :2. Discriminating betwecn paired words (24):3. Rccognizing lcucrs ( 26 ) :4. Idcnrifying irems namcd scrially (6):5. Undcrstanding scntcnces ( l5 ) :6. Following dircctionr ( l0) :7. Undcrsranding a paragraph (6):t. Rcpcatingdigits t6) :9. Rcpeatingscntences (5) :

8. Vtsuer,rxo REeorxc Dlsrunnrxcrsl. Matchingforrns (5):

2. Matching lctters (20):

3. Matching words to pictures ( 32) :4. Metching printed to spoken words ( 3l ) :5. Rcading comprehension, scnrences ( l2) :5. Rceding ratc, scntcnccs (6):

7. Rcading comprehension, paragraph ( t ) :t. Oral rceding. words ( 15 ) :9. Ord rcading. sentcnccs (30) :

C. Sruecu rxo Ler*curce Dprunaercesl. Imitating grcs movcrncntr ( l0) :2. Rapid altcrnaring rnovcmcnB ( g ) :3. Rcpcating monosyltablcs (32) :4. Repeatingphrascr (2O) :5. Counting to 20 (20) :6. Neming days of week (7) :7. Completing scntences (8) :t. Answering simple questions ( E ) :9. Givingbiographical information ( lj) :

10. Exprcssing idcas (5) :I l. Prodrrcing scntencc (6):12. Dcscribing picturc (6) :I3. Nemiry picturcs (20) :14. Defining words ( l0) :15. Rctclling paragraph (6):

D. Vrsuor,rorol ̂ ND Wnrttxo Dtsrun,rrxcgsl. Copying Grcck lerten (5) :2 Wrif ino nrrmharr r^ tn /?Ol .

3. Rcprolucing whcel (6) :4. Rcproducing lctters ( lE):5. Wriring tctrers to dictation (26):6. Writtcn spctlinl ( l0):7. Oral spclling ( l0) :t. Producing written scntenccs (6) :9. Writing scntcnccs to dictation (7) :

10. Writing a paragraph (6) :

E. DrsrurreNcEroFNuugrrcrlREt.enoxsrxo iArrrHMETrc Processes

l. Mekin3 change (t) :2. Scttingclock (5):3. Simple numerical combinerions ( l2):4. Written problcms ($) :

Suppleverrrnv Tesrs (givc namc, scorc, grade lcvet orperccntile rank;

' Pltblichcd by thc Univcrsity of Minncsota Prcss. Minocapolis. All ri3hts rescrvcd.

@ 1965 by thc Univcrity of Minncsola. hintcd in thc Unired Starcs of Amcrica. Rcviscd. t g2. Ethrh printi4. 1971.ISBN0U660361-t

t

BOOKLET FAR THE MINNESOTA TEST FOR DIFFERENTIAL DIAGNOSIS OF APHASIA

SOCIAL H ISTORy PRESENT TLLNESS con r i nucdEDUCATIoN: Lowcr cxtremitics (side and extent of involvement )_Institutiom attcnded

ambulation on adrnissiDiplomas or deSreet

OCCUPATTONAL HISTORY:

Kinds of work done

Longcst employment

PRESENT OCCUP^TIONAL STATUS :

Drtc of last cmployment palatc

Employer.Typc of TongucFAMILY:

MaritalIndividualr in home

Narne and agcs of childre-

Neercst relative

DIITCIIAT,OE PLANS:

M E D I C A L H I S T O R Y

Chcck, giving dates.Position

Ptrviow on Eram- N---Itist.?.. i.*i^i ;i;; Other'

Cgdiac involvcmcnt MENTAL STATUS:

Hypcrtension Check findings prcscnt and ratc mild, modcrate, Ecvcrei tran-Diabaes sicnt, im.provcd, persisting.I n f e c t i o n i n v o l v i n g c N s . A h r t , c o o p c r a t i v G - R e g r e s s i v c b e h a v i o r -O t h c r n e u r o | o g i c a l d i s c a s c E m o t i o n a l J a b i l i t y - D c p r e s s i o r r -ScizurcsHed iniury Confusio- Atuicty

Rclcvent sur3cry Bizarrc bchavior or responscs- Spatial disorientation-?lEvtogs cva

Sidc of paralysis paranoid reactionc OrhcrPrcscncc of aphasir sEtzuREs:Eluration of FrcqucncyrrANoEDNEss: Right( )Chief iyr iSht( )Lcf t ( ) K ind

Chicfry lcft ( ) Ambidcxtrour ( )Activiticr performcd with non-prcfcrrcd hand--

Chcck findingtDATE OF ONSET:

PN,ESENT TLLNESSprcscnt atd dcscribc.

MOTOI, FINDINCS:

Hypcrrcf,exiAbscnt or diminishcd refiexc< -

Uppcr cxtrcmitica (side and ertcnt of involvement) Skull x-rayr .

function on admissio Pncumogr

CN,ANIAL NERVES:

Ptosir

Diplopi"

Protrurlorctractio

tr.ndcnt difficultypcrsirting difficulty,

SENSON,Y FINDINGS:

Sidc of involvement

Rcduction of scnsatio

Mcdicatio

D T A G N O S T I C F I N D I N G S

Rccord datc ol cxaminarion and conclusions. l{hcn thcrc srcsignificant positive findings attach a lull rcport.

EKG

arnbulation on discharge-

Facial paralysis (side and extent of involvement)-

lateral movemc

Swallowing

function on discharge

EOOKLET FOR THE MINNESOTA TEST FOR DIFFERENTIAL DIAGNOSIS OF APHASIA

DIAcNoSTIc F tNDINGScon t i nucd CL IN ICAL RATING con r i nucd

Visual ficlds

3 Reads simplc scntences and simplc paragraph marcrials4 R-eading vocabulary of 100 or morc words: reads somc

phrascs and scntenccs5 Matchcs words to picturcs and somc spokcn to printed

words

5 No functional readingwntTtNcUnderlinc hand; R, L: preferrcd. non-prefcrred.0 No obscrvable impairmentI Can writc acceptablc letter with only minimal errors2 Spontaneous writing prcscnt. with mild impairmcnt of

spclling and formulation3 Can write short. easy scntenccl spontanco$ly and to dic-

tation

4 Spelling vocabulary of l0O or morc words: can writercmc phrases and scntcnccr

5 Can wrilc narne and a fcw words to dictation6 No functional writingDYSAI,THRIA

0 No obscrvable impairrncntI Occasional hcsitation or slurring2 lntclligiblc spccch with mild slurring or glowness3 Intclligiblc but obviously defectivc speech4 Frequent omissions and substitutionr of rcundr-( Sp:::h'::.-::!!;' b:::!;, :.::!!i;bl:6 Spccch usually unintclligiblc

Initial RatingFlrtr

Rctcst RatingFlrtr

rnrotrstntono ( )speecx ( )RE^DrNc ( )wnnwo ( )

DTAGNOSTIC SCALE(cLAsstFtcATroN outDE)

Rating scalc:0 no impairmcnt; I mild impairmcnt: 2 ttpd-cratc -impairmcnt; 3 scvcrc impirmcnt: 4 ,ro perlornanceon rchvant tcsts.

l. Anditory discrimination ( )2. Auditory recognition ( )3. Auditory rercnrion ry8n ( )

4. Visual discrimination ( )5. Visuel recoFirion ( )5. Visud rccall ( )7. Spatieloricntation ( )

8. Dysarthria ( )9. Sensorimotor involvement ( )

10. Word finding ( )I l. Ability to generatc scntcnccs in spcech ( )12. Ability to tpnerate scntencct in writing ( )

Audiomctric examinatio

Surgery

uxoersrrxonc ( )spescn ( )rE^DrN6 ( )wrnrxo ( )

Autopsy with date and causc of deatlr--

Admission diagnosi.FINAL DTAGNOSISAPHASIA (CLASSIFICATION )

Datcs of trcatfl&nt:edrnission to ctinicdischar3e from cli

CL IN ICAL RATTNG

\alf^g gb. A-6 ecording tt folb w ins guidc.UNDERSTANDINO WIL\T IS s^IDO No obscrvable irnpairment

I Follows- radio program or generat discussion with onlyminimel difficulty

2 Follows ordinary convcnntion with tittle difficulty3 Follows most convcrsation but somctima failr to 3rasp

csscntialr4 Follows simple convcrsation but requirer repctition5 Followr bricf statcmcnts with considcrablc rcpctition6 Usuatly responds inappropriatcly bccanr hc does not un-

dentand

SPEECH

0 No obscrvable impainncntI Convcrses casily with occasionel dificulty2 Conversational spccch, with mild difrculry frnding wor&

or erpressing idcas3 Somc convenational specch but merked difficulty in cx-

pressing long or compl-x idcel4 Rctdy communicarion with singlc wordr and short

phnscs5 Expresscr nccd: and wishes in limitcd or defectivc man

ncr6 No functional speechREADING

0 No obscrvable impairmentI Rceds averatc adulr materials with only minirnal diffi-

culty

2 Reads ncwspapcr and short ma3azinc matcrials

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Examples: Is Christmas in December?

Are all men six feet tall? .

Y e s ( )

Y e s ( )

N o ( )

N o ( )

t. Is an orange a fruit?

2. Arebicyclesfasterthantrains? . ' . ' ' ' '

3. Do eggs come from chickens? .

4. Do honest men usually steal?

5. Issummercolder thanwinter ' ] . . .

6. Are there twelve months in a Year?

?. Are there many highways in the United States?

8. Did the South defeat the North in the Civil War? .

9. Can anyone get a license to drive a car?

10. Is it a parent's duty to Provide for his children?

I l. Is the president of the United States aPPointed by Congress? .

12. Do people who are good drivers ever have automobile accidens?

Yes (

Yes (

Ycs (

Yes (

Yes (

Yes (

Yes (

Ycs (

Ycs (

Yes (

Yes (

Yes (

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I N o ( )

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) N o ( )

) N o ( )

) N o ( )

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) N o ( )

I N o ( )

Lawrence Griswold, a wrirer and scientist who lives in Minnesota, statcs that dragons really

exist. In 1934. he and a classmate camped for eight months on Komodo, an island in Indonesia.

Here they found dragons t 8 feet long, who walked on their hind feet like the ancicnt dinosaurs.

They lived in mountain caves and came down to prey upon animals and people in the lowlands.

Griswold and his companion trapped 43 of these strange creatures. He reponed they were disa-

greeablc reptiles with bad tempers, who hissed when they were angry. Griswold brought four of

thcm back to the United States. One died during the voyage. Two were sold to the Bronx Zoo,

and one to the Smithsonian Institution.

Qucstions:

l . D i d G r i s w o l d g o t o K o m o d o i n l g 4 3 ? . . . . Y e s ( ) N o ( )

2 . D i d h e f i n d d r a g o n s i n l n d o n e s i a ? . . . . . . Y e s ( ) N o ( )

3 .D id thcd ragons l i ve incaves in thcsea? . . .Ycs ( ) No ( )

4. Did thcy prey upon people? . . . Yes ( ) No ( )

5 .DidGr iswoldf indanydinosaurs? . .Yes( ) No( )

6 . D i d t h c y t r a p 4 3 r e p t i l e s ? . . . . Y e s ( ) N o ( )

7. Did they bring them all back to the United States? . Yes ( ) No ( )

t. Does Griswold think dragons are imaginary? . Ycs ( ) No ( )

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